Humanistic counselling plus pastoral care as usual versus pastoral care as usual for the treatment of psychological distress in adolescents in UK state schools (ETHOS):a randomised controlled trial

Background About one in seven adolescents have a mental health disorder in England, UK. School counselling is one of the most common means of trying to address such a problem. We aimed to determine the effectiveness and cost-effectiveness of school-based humanistic counselling (SBHC) for the treatment of psychological distress in young people in England, UK. Methods We did a two-arm, individually randomised trial in 18 secondary state-funded schools across the Greater London area of the UK. Participants were randomly assigned (1:1) using a centrally secure randomisation procedure with random permuted blocks to either SBHC plus schools' pastoral care as usual (PCAU), or PCAU alone. Participants were pupils aged 13–16 years who had moderate-to-severe levels of emotional symptoms (measured by a score of ≥5 on the Strengths and Difficulties Questionnaire Emotional Symptoms scale) and were assessed as competent to consent to participate in the trial. Participants, providers, and assessors (who initially assessed and enrolled participants) were not masked but testers (who measured outcomes) were masked to treatment allocation. The primary outcome was psychological distress at 12 weeks (Young Person's Clinical Outcomes in Routine Evaluation measure [YP-CORE]; range 0–40), analysed on an intention-to-treat basis (with missing data imputed). Costs were assessed at 24 weeks (Client Service Receipt Inventory and service logs). The trial was registered with ISRCTN, number ISRCTN10460622. Findings 329 participants were recruited between Sept 29, 2016, and Feb 8, 2018, with 167 (51%) randomly assigned to SBHC plus PCAU and 162 (49%) to PCAU. 315 (96%) of 329 participants provided data at 12 weeks and scores were imputed for 14 participants (4%). At baseline, the mean YP-CORE scores were 20·86 (SD 6·38) for the SBHC plus PCAU group and 20·98 (6·41) for the PCAU group. Mean YP-CORE scores at 12 weeks were 16·41 (SD 7·59) for the SBHC plus PCAU group and 18·34 (7·84) for the PCAU group (difference 1·87, 95% CI 0·37–3·36; p=0·015), with a small effect size (0·25, 0·03–0·47). Overall costs at 24 weeks were £995·20 (SD 769·86) per pupil for the SBHC plus PCAU group and £612·89 (1224·56) for the PCAU group (unadjusted difference £382·31, 95% CI £148·18–616·44; p=0·0015). The probability of SBHC being more cost-effective reached 80% at a willingness to pay of £390 for a 1-point improvement on the YP-CORE. Five serious adverse events occurred for four participants in the SBHC plus PCAU group, all involving suicidal intent. Two serious adverse events occurred for two participants in the PCAU group, one involving suicidal intent. Interpretation The addition of SBHC to PCAU leads to small reductions in psychological distress, but at an additional economic cost. SBHC is a viable treatment option but there is a need for equally rigorous evaluation of alternative interventions. Funding This work was supported by the Economic and Social Research Council (grant reference ES/M011933/1)

Developing a methodology for integration of Whole Life Costs into BIM processes to assist design decision making

A growing body of evidence suggests that the most common barrier to achieving design intent is the absence of comprehensive information during design development, leading to poor decision-making which impacts on actual building performance, and thus Whole Life Cost (WLC). Building Information Modeling (BIM) has the potential to facilitate a more comprehensive and accurate design approach from the early stages. A detailed model can allow designers and clients to understand the wider impacts of design changes, and to track this information through construction stages. However, dependencies between design decisions and WLC have yet to be understood. This paper is based on a project that focuses on the Private Rental Sector (PRS), which is the fastest growing new sector in the UK housing market. The study adopts a mixed method approach for the development and validation of a structured standardised process for timely WLC estimation through BIM. As a result, the main problems in WLC BIM management are identified, and coordinated into a reverse-engineered systematic process that uses the Integrated DEFinition (IDEF) 3 structured diagramming modeling technique. The research outputs aim to enhance BIM lifecycle management through a smart decision-making approach that is integral to the natural design development process

An evaluation of a new service model: Improving Access to Psychological Therapies demonstration sites 2006-2009, Final Report.

The Government would like to support people to move off benefits and into work. Mental health problems such as depression and anxiety are among the commonest reasons why people cannot work. These are relatively easily treated by psychological therapy, but this is hard to find in the NHS. The NHS has funded two Demonstration Sites which will make psychological therapy more widely available in sites close to peoples homes. We will look at what happens to patients in these sites, and compare it to what happens elsewhere. We will compare three kinds of places (1) The two National Demonstration Sites; (2) Places implementing their own innovations with a smaller amount of money than the Demonstration Sites and (3) Places who have not made any changes to their services, and will act as a kind of benchmark for the other two. We will compare these locations in three ways: (a) how satisfied are people with the services they receive; (b) how many people recover, and to what extent; (c) what is the financial cost of any improvement (balancing any extra costs of services against reductions in benefits claimed.) All participants will fill out some questionnaires to help us assess how their mental health has changed. We will invite a smaller number of people to have an interview, so we can hear in more detail what they liked (or did not like) about the services

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements